新生儿术中获得性压力性损伤预防和护理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2024.10.012

摘要/Abstract

摘要：

目的检索、评价并整合国内外有关新生儿术中获得性压力性损伤预防和护理的证据，为护理实践提供依据。方法按照“6S”模型检索国内外临床决策系统、指南网、专业协会网站、数据库中有关新生儿术中获得性压力性损伤评估、预防及护理等证据，检索时限为建库至2023年8月2日。纳入文献经质量评价后，由2名研究者进行证据提取及整合。结果共纳入14篇文献，其中临床决策1篇、指南4篇、证据总结3篇、系统评价2篇、专家共识4篇。从危险因素、风险评估、预防措施、观察及处理措施、人员培训5个方面总结出31条证据。结论新生儿术中获得性压力性损伤的预防和护理需要多学科协同参与。证据转化时，医护人员应根据实际情况及临床情境，选择合适的预防和护理措施，以降低新生儿术中获得性压力性损伤的发生率，保障新生儿围手术期护理安全。

关键词: 术中获得性压力性损伤, 循证护理学, 新生儿护理, 围手术期护理

Abstract:

Objective To retrieve and integrate relevant evidence on the prevention and nursing of neonatal intraoperative acquired pressure and provide a reference basis for nursing practice. Methods According to the “6S” model retrieval strategy，we searched for published articles including the following topic words，such as prevention，assessment，management，and nursing care of neonatal intra-operative pressure injury from establishment of databases until August 2，2023. We got the related references from clinical decision-making websites，guidelines network，professional association websites，domestic and foreign databases. Results Totally 14 articles were included，including 1 clinical decision support，4 clinical guidelines，3 evidence summaries，2 systematic reviews and 4 expert consensuses. Finally，31 pieces of best evidence were summarized from 5 aspects of risk factors，risk assessment，observation and preventive measures，nursing measures after the occurrence of pressure injury，education and training. Conclusion Multidisciplinary collaborative participation based on the obtained evidence is an effective strategy，which can be applied to the prevention and nursing care of neonatal intraoperative acquired pressure injury. Appropriate preventive and nursing programs should be made according to the actual situation and clinical environment，so as to reduce the incidence of neonatal intraoperative acquired pressure injury and to ensure the safety of neonatal perioperative nursing care.

Key words: Intraoperative Acquired Pressure Injury, Evidence-Based Nursing, Neonatal Nursing, Perioperative Nursing

张盼盼, 田莹莹, 陶伏莹, 崔晓花, 石秦川, 朱珠. 新生儿术中获得性压力性损伤预防和护理的最佳证据总结[J]. 中华护理杂志, 2024, 59(10): 1233-1240.

ZHANG Panpan, TIAN Yingying, TAO Fuying, CUI Xiaohua, SHI Qinchuan, ZHU Zhu. Evidence summary for the prevention and nursing of neonatal intraoperative acquired pressure injury[J]. Chinese Journal of Nursing, 2024, 59(10): 1233-1240.

图/表 5

表1 PubMed的检索策略

Table 1 PubMed search strategies

图1 文献筛选流程

Figure 1 Literature screening process

表2 纳入文献的一般特征（n=14）

Table 2 Characteristics of included studies（n=14）

表3 指南的质量评价结果（n=4）

Table 3 Quality evaluation results of the guidelines（n=4）

表4 新生儿术中获得性压力性损伤预防和护理的最佳证据总结

Table 4 Evidence summary for the prevention and nursing of neonatal intraoperative acquired pressure injury

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